Attention bias modification for depression: A systematic review and meta-analysis

Abstract

BackgroundDepression is a mental health disorder characterized by affective, somatic, and cognitive symptoms. Attention bias modification (ABM) has been widely used to treat depression. However, the results seem inconsistent. We conducted a systematic review and meta-analysis to investigate the efficacy of ABM for depression and to explore the optimal protocol of ABM.MethodsSeven databases were systematically searched from their inceptions to 5 October 2022 to include randomized controlled trials (RCTs) of ABM for depression. Two independent reviewers selected the eligible articles, extracted data, and evaluated the risk of bias using version 2 of the Cochrane risk-of-bias tool (ROB 2.0) for randomized trials. The primary outcome was the evaluation of depressive symptoms using widely accepted and validated scales. The secondary outcomes included rumination and attentional control. Meta-analysis was conducted by using RevMan (version 5.4) and Stata (version 12.0). Subgroup analyses and meta-regressions were performed to identify the source of heterogeneity. The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE).ResultsA total of 19 trials involving 20 datasets (1,262 participants) were included. The overall risk of bias in one study was rated as low risk of bias, three studies were considered as high, and the remaining studies were some concerns. Compared with attention control training (ACT), ABM had a greater effect in the improvement of depression (SMD = −0.48, 95% CI −0.80 to −0.17, I2 = 82%) and rumination (MD = −3.46, 95% CI −6.06 to −0.87, I2 = 0%). No significant differences were observed in the attentional control outcome between ABM and ACT (MD = 3.07, 95% CI −0.52 to 6.65, I2 = 0%). Subgroup analysis demonstrated that adults exhibited a greater decrease in depression scores than adolescents. ABM using the dot-probe task, training target stimulus presented by face, and training directions by left–right were associated with better antidepressant effects. ABM training delivered in the laboratory tended to yield a better effect than those conducted at home. Sensitivity analysis indicated that the results were robust. The certainty of the evidence for all outcomes was low or very low, and publication bias may exist.ConclusionDue to high heterogeneity and limited studies, not enough current evidence supported that ABM could be an effective intervention to relieve depressive symptoms. More rigorous RCTs are required to verify the benefits and to explore the optimal protocol of ABM training for depression.Systematic Review Registration: [PROSPERO], identifier [No. CRD42021279163].

AttentionCARE: replicability of a BCI for the clinical application of augmented reality-guided EEG-based attention modification for adolescents at high risk for depression

“…This is in line with the theoretical promise of using EEG-based neurofeedback to modify affect-biased attention, as EEG offers the marriage of precise neural measures and feasible clinical translation (Woody and Price, 2022 ). In addition, the current findings suggest that our BCI overcomes some of the reliability and interpretability challenges associated with previous ABMTs (Price et al, 2015 ; Rodebaugh et al, 2016 ; Xia et al, 2023 ). Finally, our use of AR technology is a novel application that could be used to enhance participant comfort and engagement.…”

“…Initial interest in modifying affect-biased attention to improve depressed mood stemmed from observations that antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), led to reductions in attention to negative information, preceding improvements in mood (Browning et al, 2010 ). Attention bias modification training (ABMT) has since been tested as a possible treatment for depression, and a recent meta-analysis from adult samples revealed that ABMT leads to significant reductions in depressive symptoms (Xia et al, 2023 ). However, this review and others (Price et al, 2015 ; Rodebaugh et al, 2016 ) have also shown that existing ABMT paradigms are limited by reliability and interpretability challenges, and there is a need to enhance the robustness and precision of these interventions.…”

Preventing and Mitigating Post-Traumatic Stress: A Scoping Review of Resilience Interventions for Military Personnel in Pre Deployment

“…This suggested better stress coping skills following Amyg-EFP-NF relative to controls. Wald et al 50 conducted attention bias modification training (ABMT) which is an intervention method, where a pre-designed processing mode is used to directly manipulate attentional bias through task scenarios, 60 and they reported four sessions of ABMT reduced risk for PTSD associated with the no-training condition. In addition, no other between-group differences were found.…”

Effects of physical exercise on executive functions of individuals with schizophrenia spectrum disorders: Protocol for a systematic review and meta-analysis

“…As in previous studies in the field [76][77][78][79], the risk of bias will be assessed using the second version of the Cochrane RoB tool (RoB2) [80] for randomized trials, classifying them as low, some concerns or high risk according to the analysis of five domains: randomization process, deviations from intended interventions, missing outcome data, measurement of the outcome, and selection of the reported result. The risk of bias will be evaluated by two authors (F.C.-O.…”